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RECEIPT - 04-99172 - AmericInn - Sign
Vk I C r _BU'Die 7y ir-�e rt � 'is C'itY of Rexburg De partm ent of COMM unity Development Receipt NLirnber: 100000000080 1Center Rexburg, ID 83440 Phone (208) 227-0562 / Fax - 3022 RCS i# Date:' { Cas h i CT -- Paye r/Paye a Nam + GOLDEN BEA a .y��_ _ - j r 7i j S^" :_ a � r+.. -+''i4 �,M _, '� TY ...:.,� "a "3SL. .A J" - " _ \ter i yf ,.. ��" - ..4 c -11 ].4 ` 7 ,� ' ' w, 'r q=.?`4�, ! 'y' - ^� ' .. .•r 4 -fid •,:41,� -y t_ -.. .i ,+�.'`' ■ "�. �y�' � �a' +k ' ,` L°_•7! i - 4 "r".;+°T " �,_ .. • - tee. 4��.. - .A'!. "bV_': _-'... .-_._- :- � - {"R'f � U� t��'S-..N,jR —'':;,iEi� � �"�,'_ f'1r"F �- `w '� rb4 -r3_�o �y'.^ s4e*'�.. . . • .#;u �4 _--+w'_.., _ • _ j -.�,. __a�lw pad- ti..;a - fid.- Loris �; }_.c.'i' �,.t L+'�r M ~ •r?.r _wg'. .r 'H � { ! a�-',, x�- . F6e �..�.�_` r .c -' - a 3, �'^ 4 �,s*�'��.�• ��- A �"�'F#fir ��� 2 7�'ai� � ��� - Tran ° g nal Fe' Sc ;�w�■ F �• L n• moi l cue 00170400172 - 4 01-322.20 $25-00 $25.00 Sign Deposit 01-322.20 $0.00 $ 75.00 $75.00 $0.00 Receipt # i Re ipt Date Previous Payment History Fed Description a m a nt --------- Che ck .Check Method Num ber CHECK 9999 Total Paym ant Amount, 100.00 $100.00 Total: $100.00 t Ald-! iP 0 ..���14 Yft� f I ofI